title: Growth of a nation part II: impact of recipient obesity on whole-organ pancreas transplantation.
abstract: Obesity has reached epidemic proportions in the USA. Consequently, there is an increasing number of obese diabetic patients who would otherwise be appropriate candidates for pancreas transplantation (PTx). This is a retrospective study of all PTx performed at Indiana University between 2003 and 2009 (n = 308) comparing recipients with body mass index (BMI) < 25, 25-29.9, and ≥30 kg/m(2) Data included recipient and donor demographics, seven and 90-d graft loss, one-yr pancreas, kidney (for SPK only) and patient survival, causes of graft loss and death, peak amylase and lipase, length of stay, readmissions, complications, HbA1C, and c-peptide. Of the 308 PTx, 100 (32%) were overweight and 42 (14%) were obese. Obese recipients were older and more likely to be men. Donor demographics were similar. There was no difference in seven-d or 90-d graft loss, one-yr pancreas, kidney or patient survival, cause of graft loss or death, 30-d peak amylase or lipase, HbA1C, or C-peptide. The incidence of post-transplant technical, immunological and infectious complications was similar except for an increased incidence of cytomegalovirus infection in the obese group. Two recipients returned to insulin therapy despite normal C-peptide levels. Although technically challenging, PTx can be successful in select obese recipients with similar results compared to normal BMI recipients.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA. jfridell@iupui.edu
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Fridell
authors.forename: Richard S
authors.initials: RS
authors.lastname: Mangus
authors.forename: Tim E
authors.initials: TE
authors.lastname: Taber
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Goble
authors.forename: Martin L
authors.initials: ML
authors.lastname: Milgrom
authors.forename: Jason
authors.initials: J
authors.lastname: Good
authors.forename: Ryan
authors.initials: R
authors.lastname: Vetor
authors.forename: John A
authors.initials: JA
authors.lastname: Powelson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002096:C-Peptide / Q000378:metabolism; D002648:Child; D003920:Diabetes Mellitus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000601:surgery*; D050177:Overweight / Q000150:complications / Q000601:surgery; D016035:Pancreas Transplantation / Q000401:mortality*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D014481:United States; D055815:Young Adult
chemical_list: D002096:C-Peptide